A nurse is teaching a client's partner how to administer an optic medication to the client. Which of the following statements by the client's partner indicates an understanding of the teaching?

Choice A Reason:
INR (International Normalized Ratio) is incorrect. INR is a measurement used to monitor the effects of anticoagulants like warfarin. It assesses the blood's ability to clot. Filgrastim does not directly affect INR levels, so monitoring INR would not provide information about the effectiveness of filgrastim in stimulating white blood cell production.
Choice B Reason:
BUN (Blood Urea Nitrogen) is incorrect. BUN levels primarily indicate kidney function and hydration status. They are not directly influenced by filgrastim treatment. Monitoring BUN is essential for assessing kidney function but does not reflect the effectiveness of filgrastim therapy in increasing white blood cell counts.
Choice C Reason:
WBC count is correct. Filgrastim is a medication that stimulates the production of white blood cells (WBCs), particularly neutrophils. Therefore, the key laboratory value to monitor for assessing the effectiveness of filgrastim therapy is the WBC count. An increase in the WBC count, particularly in the neutrophil count, signifies the intended therapeutic effect of filgrastim in boosting the immune system's response by increasing the production of these infection-fighting cells.
Choice D Reason:
Potassium level is incorrect. Potassium levels are crucial for heart and muscle function. While certain medications might affect potassium levels, filgrastim's primary action is on stimulating white blood cell production and does not directly impact potassium levels. Monitoring potassium levels is essential for overall health but does not specifically indicate the effectiveness of filgrastim treatment.

Choice A Reason:
"You should monitor for hearing difficulties." is correct. Loop diuretics like bumetanide can occasionally cause ototoxicity, resulting in hearing difficulties or ringing in the ears (tinnitus) as a potential adverse effect. It's important for clients taking these medications to be aware of such symptoms and report them promptly to their healthcare provider.
Choice B Reason:
"You should take the medication at bedtime." Is incorrect. Bumetanide is commonly prescribed to be taken in the morning to avoid nighttime diuresis and potential sleep disruption due to increased urination.
Choice C Reason:
"You should decrease your intake of foods high in potassium." Is incorrect. Loop diuretics often lead to potassium loss, so clients may actually need to increase their intake of potassium-rich foods or take potassium supplements under healthcare provider guidance to maintain normal potassium levels.
Choice D Reason:
"You should take this medication on an empty stomach." Is incorrect. Bumetanide can be taken with or without food, so it's not necessary to take it on an empty stomach.